Universal surgical stitching instrument



Jan. 29, 1946. J. D. KARLE UNIVERSAL SURGICAL STITCHING INSTRUMENT FiledJuly 8, 1945 2 Sheets-Sheet l Jan. 29, 1946. J. D. KARLE UNIVERSALSURGICAL STITCHING INSTRUMENT Filed July 8, 1945 2 Sheets-Sheet 2Patented Jan. 29, 1946 UNIVERSAL SURGICAL STITCHING INSTRUMENT John D.Karle, Rosellelark, N. 1., assignor to The Singer Manufacturing N. 1., acorporation of New Jersey Application July 8, 1M3, Serial No. 493,819

15 Claims.

This invention relates to surgical stitching instruments and moreparticularly to improvements in the instrument which forms the subjectof my pending United States patent application Serial No. 438,292, filedApril 9, 1942, which has matured into Patent No. 2,348,218, dated May 9,1944.

The primary object of this invention is to provide a universal surgicalstitching instrument which may be used as readily with the left hand aswith the right and in which the operating conditions and the position ofthe thumb-releasable spool-holder relative to the thumb of the user willbe precisely the same regardless of the hand in which the instrument isheld.

It has been found that in the use of instruments of this nature, onesurgeon will prefer to hold the instrument with his hand in oneposition, for example, with his thumb on top of the handle, whileanother will prefer to hold the instrument with his hand turnedapproximately ninety degrees about the handle so that his thumb will liebeside the handle. Also different operating conditions make it desirableto have the needle adjustable to a plurality of predetermined angularpositions about the axis of its shank.

All of these desirable features have been obtained in a surgicalstitching instrument having the improved needle-clamp actuating meansand angularly adjustable needle disclosed in my above mentionedapplication, by mounting the thumbreleasable spool-holding means on theaxis of the instrument so that it is equally accessible to the thumb ofeither the right or left hand; by so constructing and mounting thespool-holding and -locking means that interference between that meansand the needle-clamp actuating rod, which extends lengthwise through theinstrument, is

V avoided; and by so constructing the needle-holder bar that it may besecured in any one of four angular positions relative to the handle ofthe instrument and the thumb-releasable spool-holding means.

With the above and other objects in view, as will hereinafter ppear, theinvention comprises the devices, combinations,-and arrangements of partshereinafter set forth and illustrated in the,

accompanying drawings of a preferred embodiment of the invention, fromwhich the several features of the invention and the advantages attainedthereby will be readily understood by those skilled in the art.

In the drawings,

Fig. 1 is a top view of my improved instrument showing it held in oneposition in the right hand Company, Elizabethof a user with thethumb-releasable spool-holder located at the side of the instrument.

Fig. 2 is a view similar to Fig. 1 but showing the handle turned aboutthe axis of the instrument ninety degrees relative to the needle-holdingbar to bring the thumb-releasable spool-holder to the top of theinstrument, as preferred by certain users.

Figs. 3 and 4 are views similar to Figs. 1 and 2 but illustrating theinstrument as held in the left hand of a user.

Fig. 5 is a longitudinal sectional view taken on the line 5-'--5 of Fig.1.

Fig. 6 is an enlarged longitudinal sectional view taken on the line 6-6of Fig. 5 with portions of the instrument broken away.

Fig. 7 is a transverse sectional view taken on the line I-I of Fig. 6.

Fig. 8 is a transverse sectional view taken on the line 88 of Fig. 6,showing particularly the means for locating the needle-holder bar in thehandle in any one of four positions.

Fig. 9 is a sectional view taken substantially on the line 9-9 of Fig.'I.

Fig. 10 is an enlarged view of a portion of Fig. '7 showing, moreclearly, the means for locking the suture-spool against rotation in thespool-holder.

' Fig. 11 is an enlarged sectional view taken on the line I l--l I ofFig. 5 showing, more clearly, the needle-clamp and the needle heldtherein.

Fig. 12 is a disassembled perspective view of various parts of theinstrument, hereinafter to be described.

Referring more specifically to the drawings, the

invention is disclosed as embodied in a surgical stitching instrumentcomprising a handle I, a

receiving portion 3 and oppositely extending tubular members 4 and 5 ofwhich the former is adapted to fit within one end of a bore 5 formed inthe handle I and to be removably held therein by a screw l threaded intoa hole 4" in the memher I, while the opposite member 5 is formed with abore 8 adapted to receive the rear end of a hollow needle-holding bar 9.The rear or inner end of the bar 9 is formed with four slots or notchesa, b, c and d, spaced ninety degrees apart and which are adaptedselectively to receive a positioning pin Ill, carried by the member 5.In Fig. 12 the parts are shown as rotated degrees about the longitudinalaxis of the instrument,

from the position shown in Fig. 5.

shaped" needle-holding notch H. A combined needle-stop and right andleft thread-guiding member 5 extends over the head H, from onecheek-piece to the other. The walls of the V- shaped notch ll comprisethe fixed jaw of a. needle-clamp while the movable jaw of the clampconsists of the outer semi-circular wall of an aperture l6 drilled in ahead formed at one end of a needle-clamp actuating rod IS. The head i1is slidably mounted between the cheekpieces I2 and I3. The rod l8extends through bores in the needie-bar 3 and spool-holding section 2and through the hollow handle I to adjacent the free end of the handlewhere it is threaded into a clamp-actuating nut l3 having a knurledportion which abuts the free end of the handle. A coil spring 20surrounding the rod l8, within the hollow handle, has one end bearingagainst a shoulder 2| in the handle and its other end bearing againstthe nut I9. This spring normally urges the two jaws of the needle-clampinto yielding contact with the octagonal shank 22 of the needle 12thereby permitting the needle to be rotated in the clamp, about the axisof its shank,

, without dropping from the needle-clamp. Rotation of the nut IS, in onedirection, serves to increase the pressure of the jaws on th needleshank and causes the needle to be positively locked in its predeterminedangular positions. This needle-clamp and its actuating means are fullydisclosed in my above mentioned application Serial No. 438,292. The pullof the needle-clamp actuating rod l8 serves to hold the needle-bar inthe portion 5 of the spool-holding section 2 and prevents accidentalseparation of the pin Ill from the engaged slot a, b, c or d in theneedle-bar. The needle-bar 9 and the clamp-actuating rod l8 may ,be madeof any desired length or bars and rods of various lengths may beprovided.

When it is desired to remove the needle-bar for the purpose of cleaningor angular adjustment, the nut I3 is unscrewed from the rod l8, therebypermitting the rod and the needle-bar to be drawn outwardly from thesection 2.

Suture thread t, for the needle, is wound upon a spool 23 held withinthe cup-like spool-case 3 of the spool-holding section 2, intermediatethe needle-bar 9 and the handle The thread t runs from the spool 23through a slot 24 in the side wall of the spool-case 3, thence throughthe thread-guide l5 and finally to the eye, or eyes, of the needle. Thespool is rotatably journaled on the portion 25* of a spool-supportingpin or rod 25 against a collar 26 formed thereon. The spoolcase 3 isclosed, to protect the suture thread and to prevent contaminationthereof, by a sheet metal cover or cap 21 which is supported on thespool-pin 25 and telescopes with the spool case. A knurled nut 28threaded, onto the portion 25 of the spool-pin holds the cap 21 in itsnormal operative position.

At the side of the collar 26 remote from the portion 25, on which thespool is mounted, the spool-pin has an enlarged portion 25 which is sidingly mounted in a transverse bore 29 formed.

in the section 2 and in a boss 30 projecting therefrom. A cup-nut 3|,which also serves as a thumb-button, is threaded upon the end 25 of thespool-pin and serves as means to shift the pin axially, in onedirection, in opposition to a coil spring 32 surrounding the boss 30intermediate the member 2 and the nut 3|.

Provision is made for locking the spool against rotation except when itis desired to. draw suture thread therefrom. To that end, each flange ofthe spool 23 is formed with a series of apertures 23" adapted to receivethe head of a screw 33, located within the spool-case 3, to preventrotation of the spool. The screw 33 also serves to hold, within thespool-case, a light C-shaped flat metal friction spring 33, adapted tobear upon the innermost flange of the. spool to prevent overrunning ofthe spool when it is released from the screw 33, as will now bedescribed.

When it is desired to unlock the spool from the screw 33 so that thespool will be free to rotate to permit suture thread tobe withdrawn fromthe spool, the user presses on the thumb-button 3| thereby shifting therod 25, and the spool carried thereby, axially away from the screw 33,as illustrated in dotted lines in Fig. 10. Upon release of the pressureupon the thumb-nut the spring 32 4 ts the parts in the oppositedirection again 0 to bring one of the holes 23 in the spool 23, intolocking engagement with the head of the screw 33. As hereinbefore statedthe suture spool and its locking and unlocking means are located on thelongitudinal axis of the instrument so as to be equally accessible tothe thumb of either hand. When so located the axis of the spool pinintersects the axis of the clamp-actuating rod l8. To permit the partsto have this desirable location and yet toavoid interference between thespool-pin and the needle-clamp actuating rod 1 have so formed the partsthat one may pass transversely through the other. Preferably the portionI 25 of the spool-pin 25 is formed with a transverse clearance aperture25 which is of suflicient 35 width to permit the needle-clamp actuatingrod I! to pass therethrough, as shown in Figs. 5, 6, 7 and 10. Also, theaperture 25 is sufliciently long to permit the spool-pin to be shiftedlengthwise, under thumb-pressure applied to the thumb-button 3| or bythe spring 32, to cause the spool to be released from or locked to thescrew 33, as hereinbefore described. 7 I

To prevent the spool-pin from turning in the section 2 when the rod I8is withdrawn, the collar 26 is formed with an arcuate notch 26 whichfits upon a complemental rounded portion 34 of the spool-tensioningspring 34, as shown most clearly in Figs. 9 and 10.

In Fig. 1 the instrument is shown as held in the needle-bar 9 is rotatedninety degrees about its axis from the position shown in Figs. 1 and 8so that the slot b in the free end 'of the bar engages the positioningpin Ill, thereby, in efiect, rotating the handle and the spool holderninety degrees from the position shown in Fig. 1 in the directionindicated by the arrow :4: in that figure.

Fig. 3 shows the instrument held in the left hand of a user with theparts in the same position relative to the left hand as are the parts inFig. 1 to the right hand. To obtain this positioning of parts, theinstrument is turned end for end. the needle-bar is inserted into thesection 2 with the notch c in engagement with the pin II and the needleis rotated 180 degrees about the right hand of a user with thespool-releasing 3| is above the instrument, as shown in Fig. 2,

the axis of its shank from the position e in Fig. 1 to the position i inFig. 3.

Fig. 4 shows the handle'turned in the direction indicated by the arrow1,: in Fig; 3 ninety degrees relative to the needle-bar and needle fromthe position shown in Fig. 3. This is effected by inserting theneedle-bar into the section 2 with the notch d therein in engagementwith the pin Hi.

It is to be understood that bec use of the octagonal cross-sectionalshape of t e shank of the needle and the construction of theneedleclamp, the needle may also be shifted to and positively locked ineach or the other angular positions 3, g, 11,1 and l, as shown in Figs.1 and 3 as may be required for various suturing conditions or to thesafety position k, in which the needle underlies the needle-bar, for thepurpose of handling or transportation.

Having thus set forth the nature of the invention, what I claim hereinis:

1. A surgical stitching instrument comprising a handle; a spoolholdingsection secured to said handle in axial alignment therewith; aspool-case provided by said section and having its axis perpendicular toand intersecting the longitudinal axis of said section; means to lock aspool against rotation in said spool-case; a manually actuablespool-lock releasing rod arranged coaxial with said spool-case; aneedle-carrying bar removably secured in said spool-holding section inaxial alignment with said section and handle; a needle-clamp at 'thefree end of said bar; and a needle-clamp actuating rod extending throughsaid needle-bar, spool-holding section and handle and intersecting theaxis of said spool-lock releasing rod, one of said rods having anaperture therethrough to permit passage of the other rod;

2. A surgical stitching instrument comprising a handle; a spool-holdingsection carried by said handle and in axial alignment therewith; aneedle-carrying bar removably secured in said spoolholding section inaxial alignment with said section and handle; and cooperatinginterengaging means provided by said needle-bar and said section toposition the needle-bar in a plurality oi predetermined angularpositions in said section.

3. A surgical stitching instrument comprising a handle; a spool-holdingsection carried by said handle and in axial alignment therewith; aneedle-carrying bar having one end fitted within said spool-holdingsection in axial alignment with said section and handle, said end havingtherein a plurality of notches; and a positioning element located insaid spool-holding section and adapted to enter any one of said notchesto hold said needle-bar in any one of a plurality of angular positions.

4. A surgical stitching instrument comprising a handle; a spool-holdingsection carried by said handle and in axial alignment therewith; aneedle-carrying bar having one end fitted within said spool-holdingsection in axial alignment with said section and handle, said end havingtherein a plurality of circumferentially spaced openended slots; and apositioning element carried by said section and adapted selectively tobe inserted into any one of said slots to hold said needle-bar in anyone of a plurality of angular positions relative to said spool-holdingsection and handle.

said spool-holding section in axial-alignment with said section andhandle. said end having therein a plurality of circumferentially spacedopen-ended slots; a positioning element carried by said section andadapted-selectively to be inserted into any one of said slots to holdsaid needle-bar in any one of a plurality of angular positions relativeto said section and handle; a fixed needle-clamping'jaw at theouter endof said needle-bar; a movable needle-clamping jaw cooperating with saidfixed jaw to clamp a needie; and means extending through said needlebar,spool-holding section and handle to draw said movable clamping jaw intoneedle-clamping position and to hold said needle-bar against outwardmovement relative to said positioning element. a

6. A surgical stitching instrument comprising a hollow handle; aspool-holding section having a cup-like spool-holding portion and. twotubular portions extending in opposite directions therefrom, one of saidtubular portions being secured within the axial bore in said handle; aneedle-bar having one end secured within the other tubular portion ofsaid spool-holding section; a needle-clamp at the opposite end of saidneedle-bar; a needle-clamp actuating rod ex tending through saidneedle-bar, spool-holding section and handle; and means at the free endof said handle for actuating said needle-clamp actuating rod.

7. A surgical stitching instrument comprising a hollow handle; aspool-holding section having a central portion and two tubular portionsextending in opposite directions therefrom, one of said tubular portionsbeing secured within said handle; a cup-like spool-case provided .bysaid central portion having its axis perpendicular to and intersectingthe axis of said tubular portions; a needle-bar having one end securedwithin the other tubular portion of said spool-holding section; -aspool-supporting pin mounted in said central portion coaxial with saidspool-case, said spool-pin having a transverse bore therethrough; aneedle-clamp at the opposite end of said needle-bar; a needle-clampactuating rod extending through the bores in said needle-bar,spool-holding section, spool-pin, and handle; and means at the free endof said handle for actuating said needle-clamp actuating rod.

8. A surgical stitching instrument comprisin I a hollow handle; aspool-holding section having a spool-holding portion and two tubularportions extending in opposite directions therefrom, the inner of saidtubular portions being secured within said handle; a cup-like spool-caseprovided by said central portion having its axis perpendicurotation;thumb-actuated means for shifting said 5. A surgical stitchinginstrument comprising die-carrying bar having one end fitted withinspool-pin and spool axially to release said spoollocking means; aneedle-clamp at the outer end of said needle-bar; a needle-clampactuating rod extending through the bores in said needlebar,spool-holding section spool-pin and handle; and means at the free-end ofsaid handle for actuating said needle-clamp actuating rod.

9. A surgical stitching instrument as set forth in claim 8 in which theside wall oi the spoolvided between the spool-pin and the spool-holdingsection to prevent rotation of the spool-pin while permitting axialmovement thereoi'. V

11. A universal surgical stitching instrument comprising a handle; a.spool-holding section carried by said handle and having its major axisin alignment with the axis of said handle, said section including aspool-case having its axis arranged transversely of said major axis;means to look a suture spool against rotation in said spool-case; meansincluding an endwise movable rod extending axially through saidspool-case and having a thumb-button on one end thereof for releasingsaid spool-lock; a needle-bar adapted t have one end thereof removablysecured in any one of a plurality of predetermined angular positions insaid spool-holding section at'the side or said spool-case opposite saidhandle; a needie-clamp at the free end of said needle-bar; and a needleadapted to be secured in said needleclamp in any one of a plurality ofpredetermined angular positions, the angular adjustments of saidneedle-bar and needle permitting the instrument selectively to beassembled for, identical operating conditions whether held in the rightor'left hand of a user.

12. A universal surgical stitching instrument comprising a handle; aspool-holding section carried by said handle and having its major axisin alignment with the axis of said handle, said section including aspool-case having its'axis arranged transversely of and intersectingsaid major axis; means to look a suture spool against rotation in saidspool-case; means including a thumb-actuated endwise movable rod, havingan elongated transverse aperture therethrough, extendingaxially throughsaid spool-case for releasing said spool-lock; a needle-bar adapted tohave one end thereof removably secured in any one of a plurality ofpredetermined angular positions in said spool-holding section; aneedleclamp at the free end of said needle-bar; a needle-clamp actuatingrod extending through the bores in said needle-bar, spool-holdingsection, spool-releasing rod and handle; a nut threaded on saidclamp-actuating rod to shift it axially;

and a needle adapted to be secured in-said needleclamp in any one of aplurality or predetermined angular positions, the angular adjustments ofsaid needle-bar and needle permitting the instrument selectively to beassembled for identical operating conditions whether held in the rightor left hand oi a user. p

13. A universal surgical stitching instrument comprising a handle; aspool-holding section secured thereto and including a spool-case andthumb-controlled means for looking a suture spool therein; a needle-barhaving one end removably secured in said section; a needle secured inthe opposite end 01' said needle-bar; and means for efiecting relativeangular adjustment between said needle-bar and said section togcause thehandle and the thumb-controlled spool-locking means to have a pluralityof predetermined angular positions in a hand of a user without changingthe position of the needle.

14. A universal surgical stitching instrument comprising a handle; aspool-holding section secured thereto and including a spool-case andthumb-controlled means for locking 9. suture spool therein, the axes ofsaid spool-case and thumb-controlled means being arranged perpendicularto and intersecting the axis of said handle; a needle-bar having one endsecured in said section; a needle-clamp at the free end 0! saidneedle-bar; a needle secured in said needleclamp; a needle-clampactuating rod extending axially through said needle-bar, spool-holdingsection and handle; and means for eil'ecting relative angular adjustmentbetween said needle-bar and said section to cause the handle and thethumb controlled spool-locking means to have a plurality ofpredetermined angular positions in a hand of a user without changing theposition of the needle-clamp and needle.

15. A universal surgical stitching instrument comprising a handle; aspool-holding section se-

